Category: Nevin Manimala

Sociol Health Illn. 2021 Oct 15. doi: 10.1111/1467-9566.13386. Online ahead of print.

ABSTRACT

Despite numerous studies on social relationships and health, the empirical focus has often been on middle-aged or older adults, even though young adulthood is a period of considerable change in social networks. We investigated whether the associations between social relationships and allostatic load, a multisystem physiological dysregulation index that reflects chronic stress responses, vary by type of relationship and stages of the lifecourse. Relationships with spouse/partner, immediate family and friends were assessed in terms of emotional support and social strain. Poisson regression models on multiple imputed data sets from waves 2-3 (2010-2012) of the UK Household Longitudinal Study (N = 10,380) were estimated. Social strain, particularly from partners and immediate family, appeared to elicit greater stress related dysregulation during early adulthood (age 21-34 years), corresponding to a predicted difference in the allostatic load index (range 0-12) between high and low strained relationships of 1.1 (95% CI: 0.5-1.6) among young women and 0.6 (95% CI: -0.04 to 1.2) among young men. There was little evidence of an association between allostatic load and any of the social relationships among older men and women. Models of social relationships over the lifecourse need to take account of how stressful social relationships become biologically embedded in early adulthood.

PMID:34655081 | DOI:10.1111/1467-9566.13386

Stat Med. 2021 Oct 15. doi: 10.1002/sim.9228. Online ahead of print.

ABSTRACT

Control risk regression is a diffuse approach for meta-analysis about the effectiveness of a treatment, relating the measure of risk with which the outcome occurs in the treated group to that in the control group. The severity of illness is a source of between-study heterogeneity that can be difficult to measure. It can be approximated by the rate of events in the control group. Since the estimate is a surrogate for the underlying risk, it is prone to measurement error. Correction methods are necessary to provide reliable inference. This article illustrates the extent of measurement error effects under different scenarios, including departures from the classical normality assumption for the control risk distribution. The performance of different measurement error corrections is examined. Attention will be paid to likelihood-based structural methods assuming a distribution for the control risk measure and to functional methods avoiding the assumption, namely, a simulation-based method and two score function methods. Advantages and limits of the approaches are evaluated through simulation. In case of large heterogeneity, structural approaches are preferable to score methods, while score methods perform better for small heterogeneity and small sample size. The simulation-based approach has a satisfactory behavior whichever the examined scenario, with no convergence issues. The methods are applied to a meta-analysis about the association between diabetes and risk of Parkinson disease. The study intends to make researchers aware of the measurement error problem occurring in control risk regression and lead them to the use of appropriate correction techniques to prevent fallacious conclusions.

PMID:34655089 | DOI:10.1002/sim.9228

Urol J. 2021 Oct 13. doi: 10.22037/uj.v18i.6503. Online ahead of print.

ABSTRACT

PURPOSE: The prevalence of erectile dysfunction in men is increasing. As well, the prevalence of diabetes, as one of the causes of sexual dysfunction, is rising in many countries. Due to the failure of common therapies in some patients with sexual dysfunction, it is necessary to develop an effective alternative treatment, such as stem cell therapy, for this problem.

MATERIALS AND METHODS: In this randomized single-blinded clinical trial, 20 diabetic patients with erectile dysfunction, who were resistant to common treatments, were selected and divided into two groups of intervention and control (n=10 per group). Autologous mesenchymal stem cells (MSCs) were extracted from oral mucosa and then infused via intracavernosal injection (50-60 106 cells) to the participants of the intervention group. Normal saline was injected in the control group. The patients were followed up with the International Index of Erectile Function (IIEF5) questionnaire, as well as color Doppler duplex ultrasound. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were determined at three and six months after the interventions.

RESULTS: The mean IIEF5 scores in the intervention group were 7.2 ± 2.1, 9.2 ± 3.4, and 10.6 ± 4.7 before, three months, and six months after the injection, respectively, showing a significant ascending trend (p value = 0.01). Comparing the intervention and control groups, there was a significant difference in the IIEF5 score change during six months after the injection (p value = 0.02). Regarding the PSV and RI of penis vessels, there were no statistically significant differences between the two groups. However, these parameters showed upward and improving trends in the intervention group.

CONCLUSION: Intracavernosal injection of stem cells improved sexual function and PSV and RI indices of penile arteries in diabetic patients.

PMID:34655071 | DOI:10.22037/uj.v18i.6503

Urol J. 2021 Oct 16. doi: 10.22037/uj.v18i.6626. Online ahead of print.

ABSTRACT

PURPOSE: Prostate canceris the most commonly diagnosed type of cancer and one of the leading causes of cancer-related death in men.Numerous efforts have been made to improve existing diagnostic methods and develop a new biomarker to identify patients with prostate cancer. In line with current literature, we preferred new serum-based biochemical markers as Pentraxin-3, Fetuin-A and Sirtuin-7 in the present study.

MATERIALS AND METHODS: A total of 174 patients aged 42-76 years were included in the study. Patients with prostate cancer (n=38) were enrolled as Group 1 and patients with benign prostatic hyperplasia (n=136) as Group 2. The serum levels of Pentraxin-3, Fetuin-A and Sirtuin-7 levels were compared between the groups.

RESULTS: The mean age of the patients was 61.9±7.6 years (p= .001). The mean serum Prostate Specific Antigen levels 32.0±59.6 (2.6-336) ng/mL and 10.0±11.3 (2.5-77.4) ng/mL in Group 1 and 2, respectively (p= .029). The mean serum levels of Pentraxin-3 and Fetuin-Ain Group 1 were statistically significantlydifferent from Group 2(3.3±4.4 ng/mL vs 1.8±2.4 ng/mL, p= .002 and 466.8±11.0 µg/mL vs 513.3±11.0 µg/mL,p= .041,respectively). There was no significant difference between Group 1 and 2 according to serum levels of Sirtuin-7 (12.7±8.2 ng/mL vs 12.7±12.4 ng/mL respectively, p= .145).

CONCLUSION: Pentraxin-3, Fetuin-A and Sirtuin-7 may be effective in the diagnosis of prostate cancerin light of the current literature.In this study, it was found that Pentraxin-3 and Fetuin-A were significantly different in the diagnosis of prostate cancer.Larger-scale prospective studies are needed to determine the importance of Pentraxin-3 and Fetuin-A in the diagnosis of prostate cancer.

PMID:34655076 | DOI:10.22037/uj.v18i.6626

J Cancer Surviv. 2021 Oct 16. doi: 10.1007/s11764-021-01119-2. Online ahead of print.

ABSTRACT

PURPOSE: Social support is associated with breast cancer survivors’ health-related quality of life (HRQoL). More nuanced information is needed regarding aspects of social support associated with different HRQoL domains among diverse populations. We assessed the association between emotional/informational and tangible support and five HRQoL domains and evaluated race as an effect modifier.

METHODS: African American and White women (n = 545) diagnosed with hormone-receptor-positive breast cancer completed a survey that assessed sociodemographic, clinical, and psychosocial factors. We assessed bivariate relationships between emotional/informational and tangible support along with overall HRQoL and each HRQoL domain.We tested interactions between race and emotional/informational and tangible social support using linear regression.

RESULTS: The sample included African American (29%) and White (71%) breast cancer survivors. Emotional/informational social support had a statistically significant positive association with emotional well-being (β = .08, p = 0.005), social well-being (β = 0.36, p < 0.001), functional well-being (β = .22, p < .001), breast cancer concerns (β = .16, p = 0.002), and overall HRQoL (β = .83, p < .001). Similarly, tangible social support had a statistically significant positive association with emotional well-being (β = .14, p = 0.004), social well-being (β = .51, p < .001), functional well-being (β = .39, p < .001), and overall HRQoL (β = 1.27, p < .001). The interactions between race and social support were not statistically significant (p > 0.05).

CONCLUSIONS: Results underscore the importance of the different social support types among breast cancer survivors, regardless of survivors’ race.

IMPLICATIONS FOR CANCER SURVIVORS: Population-based interventions can be standardized and disseminated to provide guidance on how to increase emotional/information and tangible support for all breast cancer survivors by caregivers, health providers, and communities.

PMID:34655040 | DOI:10.1007/s11764-021-01119-2

Thorac Cardiovasc Surg. 2021 Oct 15. doi: 10.1055/s-0041-1735496. Online ahead of print.

ABSTRACT

BACKGROUND: Unilateral diaphragmatic paralysis or paresis (UDP) in adults is an often overlooked disease which relevantly impairs the patient’s lung function and quality of life. Particularly in idiopathic UDP, there is no evidence for conservative therapy and only little evidence for surgical therapy.

METHODS: The method involves retrospective single-center analysis of patients with UDP persistent for at least 1 year who were operated by diaphragmatic resection, plication, and augmentation with a polypropylene mesh. The patients were tested for lung and diaphragmatic function, six-minute walk test (6MWT), and blood gas analysis before, 3 and 12 months after surgery.

RESULTS: In total, 85 patients received surgery for UDP. The most frequent reasons for UDP were idiopathic (67%), iatrogenic (mainly cardiac and cervical spine surgery; 24%), and trauma (9%). The mean operation time was 84 ± 24 minutes, the length of hospital stay 8.4 ± 3.9 days, chest tubes were removed after 11.7 ± 4.1 days. Overall morbidity was 42%, mortality 0%. Forced expiratory volume in one second (FEV₁) in supine position improved by 12.4% absolute, vital capacity by 11.8% absolute, and sniff nasal inspiratory pressure by 1.4 kPa 12 months after surgery (p <0.001 each). Total lung capacity increased by 6.8% absolute at 12 months (p = 0.001) The 6MWT distance improved by 45.9 m at 3 months and 50.9 m at 12 months (p = 0.001, each).

CONCLUSION: Surgical therapy for UDP is highly effective in the long term. The superiority over conservative treatments needs to be evaluated prospectively with standardized physiotherapeutic protocols. FEV₁ in supine position and 6MWT are easy to perform tests and represent statistically and patient-relevant outcomes.

PMID:34655069 | DOI:10.1055/s-0041-1735496

J Clin Immunol. 2021 Oct 16. doi: 10.1007/s10875-021-01145-w. Online ahead of print.

ABSTRACT

Unconditioned hematopoietic stem cell transplantation (HSCT) is the recommended treatment for patients with adenosine deaminase (ADA)-deficient severe combined immunodeficiency with an HLA-matched sibling donor (MSD) or family donor (MFD). Improved overall survival (OS) has been reported compared to the use of unrelated donors, and previous studies have demonstrated that adequate cellular and humoral immune recovery can be achieved even in the absence of conditioning. Detailed insight of the long-term outcome is still limited. We aim to address this by studying a large single-center cohort of 28 adenosine deaminase-deficient patients who underwent a total of 31 HSCT procedures, of which more than half were unconditioned. We report an OS of 85.7% and event-free survival of 71% for the entire cohort, with no statistically significant differences after procedures using related or unrelated HLA-matched donors. We find that donor engraftment in the myeloid compartment is significantly diminished in unconditioned procedures, which typically use a MSD or MFD. This is associated with poor metabolic correction and more frequent failure to discontinue immunoglobulin replacement therapy. Approximately one in four patients receiving an unconditioned procedure required a second procedure, whereas the use of reduced intensity conditioning (RIC) prior to allogeneic transplantation improves the long-term outcome by achieving better myeloid engraftment, humoral immune recovery, and metabolic correction. Further longitudinal studies are needed to optimize future management and guidelines, but our findings support a potential role for the routine use of RIC in most ADA-deficient patients receiving an HLA-identical hematopoietic stem cell transplant, even when a MSD or MFD is available.

PMID:34654999 | DOI:10.1007/s10875-021-01145-w

Jpn J Ophthalmol. 2021 Oct 16. doi: 10.1007/s10384-021-00879-9. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to identify the characteristics of acute acquired comitant esotropia (AACE) in young patients from a single institution; and clarify their relationship with the excess use of digital devices.

STUDY DESIGN: Retrospective, observational.

METHODS: We extracted the clinical charts of patients aged between 5 and 35 years who presented at the Hamamatsu University Hospital with AACE symptoms from January 1, 2015 to December 31, 2018. The age of onset, angle of deviation, refractive errors, history of near work, including excess smartphone use, and treatment modality were retrieved. Patients were divided into three groups: CHILD (aged 5-12 years), JUNIOR (aged 13-17 years), and ADULT (aged 18-35 years) and statistically analyzed with Kruskal-Wallis test.

RESULTS: Forty-one patients were retrieved, with a mean age at onset of 15.8 (5-28) years; eight in the CHILD group, 23 in the JUNIOR group, and 10 in the ADULT group. Refractive errors and age of patients were correlated, but were not significantly different among groups. The mean angle of deviation at distance was 28.0 ± 12.8 prism diopters (PD) and 28.6 ± 17.2 PD at near. The CHILD group showed the largest near-distant dissociation. History of excessive near work was found in all groups.

CONCLUSION: AACE was most commonly found in the JUNIOR group, especially those aged 15-16 years. AACE may encompass multiple diseases; using common diagnostic criteria and asking common questions regarding digital device usage is necessary to clarify the influence of digital device usage, and a multicenter prospective study is recommended.

PMID:34655005 | DOI:10.1007/s10384-021-00879-9

J Immigr Minor Health. 2021 Oct 16. doi: 10.1007/s10903-021-01295-4. Online ahead of print.

ABSTRACT

Since the outbreak of COVID-19, there has been a surge of discrimination against Asians across the globe. However, there is a knowledge gap of COVID-19 related racial discrimination against Asians in smaller Asian populations. A total of 221 adults living in Florida completed an online survey between June-July 2020. Adjusted logistic regression assessed associations between sociodemographic factors and experienced discrimination, hypervigilance of safety, nervousness in public, and anticipated discrimination. Statistical analyses were performed using SPSS. Asian respondents were more likely than non-Asians to experience discrimination during COVID-19 (AOR = 12.58; 95% CI 4.74, 33.38; p ≤ 0.001). Asians were more likely to anticipate discrimination after the pandemic ends (AOR = 4.35, 95% CI 1.33, 14.17; p < 0.05). We found that Asians in smaller Asian populations suffer from a disproportionate level of discrimination due to COVID-19, relative to non-Asians. Our findings support previous research that racial discrimination exists on a continuum of violence and can have severe negative health consequences.

PMID:34654994 | DOI:10.1007/s10903-021-01295-4

Bull Math Biol. 2021 Oct 15;83(11):117. doi: 10.1007/s11538-021-00947-8.

ABSTRACT

The contact structure of a population plays an important role in transmission of infection. Many ‘structured models’ capture aspects of the contact pattern through an underlying network or a mixing matrix. An important observation in unstructured models of a disease that confers immunity is that once a fraction [Formula: see text] has been infected, the residual susceptible population can no longer sustain an epidemic. A recent observation of some structured models is that this threshold can be crossed with a smaller fraction of infected individuals, because the disease acts like a targeted vaccine, preferentially immunising higher-risk individuals who play a greater role in transmission. Therefore, a limited ‘first wave’ may leave behind a residual population that cannot support a second wave once interventions are lifted. In this paper, we set out to investigate this more systematically. While networks offer a flexible framework to model contact patterns explicitly, they suffer from several shortcomings: (i) high-fidelity network models require a large amount of data which can be difficult to harvest, and (ii) very few, if any, theoretical contact network models offer the flexibility to tune different contact network properties within the same framework. Therefore, we opt to systematically analyse a number of well-known mean-field models. These are computationally efficient and provide good flexibility in varying contact network properties such as heterogeneity in the number contacts, clustering and household structure or differentiating between local and global contacts. In particular, we consider the question of herd immunity under several scenarios. When modelling interventions as changes in transmission rates, we confirm that in networks with significant degree heterogeneity, the first wave of the epidemic confers herd immunity with significantly fewer infections than equivalent models with less or no degree heterogeneity. However, if modelling the intervention as a change in the contact network, then this effect may become much more subtle. Indeed, modifying the structure disproportionately can shield highly connected nodes from becoming infected during the first wave and therefore make the second wave more substantial. We strengthen this finding by using an age-structured compartmental model parameterised with real data and comparing lockdown periods implemented either as a global scaling of the mixing matrix or age-specific structural changes. Overall, we find that results regarding (disease-induced) herd immunity levels are strongly dependent on the model, the duration of the lockdown and how the lockdown is implemented in the model.

PMID:34654959 | DOI:10.1007/s11538-021-00947-8